SummaryThis review highlights recent progress in the use of embryonic stem cell (ESC) systems for studying and treating cardiovascular disease. Although ESCs represent an in vitro system, they can provide a rich source of progenitor cells, and this has been exploited recently to identify novel precursors and to investigate the lineage relationships among various cell types that comprise the developing heart, including cardiac muscle, endothelium, and smooth muscle. ESCs grown in aggregates (embryoid bodies) recapitulate normal developmental programs. Since they can be grown under defined culture conditions, they have been used to systematically identify specific genes and signaling pathways that promote cardiogenesis. A major goal is to optimize the production of cardiac progenitors and differentiated cell types, and to test their ability to promote healing in transplant assays, for example post-infarction. While many challenges remain, the development of iPS technology provides a means to generate cells for autologous transplant and for investigating patient-specific disease mechanisms. The development of new techniques to derive cardiac derivatives in vitro from ESC or iPS sources, coupled with novel tissue-engineering approaches and a better understanding of how explanted cells can survive and integrate in host tissue, should have a significant impact on the development of both cell-based and pharmacological therapies for cardiovascular disease.
Keywords
cardiogenesis; progenitors; cell therapies; iPSCan heart development and disease be studied in vitro?Organogenesis is a complex process that transforms relatively homogenous epithelial germ layers into functioning and highly integrated systems. From a developmental perspective, this can be viewed as a series of cellular transitions, including the commitment of progenitors to tissue-restricted fates, differentiation to express lineage-restricted genetic programs, morphogenesis to form appropriate tissue shapes, and system integration to incorporate the organ into the physiological state of the developing embryo. While the development of any organ system is remarkably complex, cardiogenesis requires extraordinary coordination of regulatory mechanisms in both time and space. In particular, both subtle and dramatic morphogenetic movements transform an initial primordial tube into a complex 3-dimensional organ consisting of septated chambers with distinct identities, a coronary vasculature and mature valves. Integration with both the venous and arterial systems must be timed perfectly 1300 York Ave. LC-709, New York, NY 10021, 212-746-5143, 212-746-8753 (fax), tre2003@med.cornell.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors...